Senate hearing spotlights New York maternal mortality; health officials cite preventable deaths, workforce gaps

New York State senators convened a joint hearing on maternal mortality and morbidity in a session dominated by state Department of Health officials, clinicians and community advocates who said most pregnancy‑related deaths in the state are preventable and urged faster implementation of programs and investments to close racial and geographic gaps.

The hearing opened with New York State Senator Leah Webb, chair of the Senate Committee on Women's Issues, who framed the session around recent state data and the heavy toll borne by Black birthing people. Joanne Morne, Executive Deputy Commissioner of the New York State Department of Health, and Dr. Kirsten Siegenthaler, director of the Division of Family Health, presented the department's overview of programs already in place and the limits those programs face.

The numbers cited at the hearing underscored the officials' urgency. Department staff said a CDC‑supported review of 2018–2020 data identified 386 pregnancy‑associated deaths in New York; of those, 121 were classified as pregnancy‑related. Department figures presented at the hearing showed Black people accounted for roughly 14.3 percent of live births but about 42.1 percent of pregnancy‑related deaths in that period. The department and legislators repeatedly described roughly three‑quarters of pregnancy‑related deaths as having some or good likelihood of being preventable.

Why it matters: senators and witnesses said prevention requires both clinical quality improvement and broader social‑services investments. “There is a critical influence of economic, societal, and environmental factors on maternal health,” Morne told the committee, listing workforce shortages, care continuity gaps and structural racism as leading contributors. Senators and panelists said those nonclinical factors — housing, transportation, food access and insurance continuity — often determine whether pregnant and postpartum people receive timely care.

What the Department of Health described: Morne and Dr. Siegenthaler described multiple state efforts, including the New York State Maternal Mortality Review Board (established in 2019), the voluntary New York State Perinatal Quality Collaborative, regional perinatal center grants, expanded Medicaid benefits (including extension of postpartum Medicaid from 60 days to 12 months), and a state advertising campaign drawn from the CDC "Hear Her" materials to encourage pregnant people to report concerning symptoms. The department also said recent budgets include $16,000,000 in annual state funding for maternal and infant public‑health initiatives and that state funds are intended to be matched by federal dollars.

Officials also detailed workforce gaps. Dr. Siegenthaler cited a shortage of clinicians: “Of 47 counties in New York State, there are fewer than 10 obstetricians per 100,000 population. Of those 47 counties, 10 of those counties have fewer than 6,” she said, adding that shortages affect obstetricians, midwives, nurses and anesthesiologists and contribute to so‑called maternal care deserts.

Community and provider testimony: Multiple panels of midwives, doulas, hospital clinicians and advocates told senators where they think work is needed. Speakers described: - Doula access and training: advocates and community doula trainers asked the state to speed contracting and payer enrollment so trained doulas can bill Medicaid. Department officials said two training programs were recently funded and contracts were being executed; Medicaid enrollment numbers and geographic sign‑ups were not available at the hearing but were promised as follow‑up. - Midwifery and birth centers: midwives and the New York State Birth Center Association urged state support for out‑of‑hospital birth options and for recognition/licensure pathways for certified professional midwives (CPMs). Witnesses said no new birth centers had been licensed since the 2021 law, and they requested startup help (site control, malpractice cost mitigation, technical assistance) to expand birth‑center access. - Clinical quality work: ACOG representatives and hospital clinicians described quality improvement work that reduced cesarean rates and hemorrhage outcomes where instituted, and urged continued investment in bundles, checklists and the state’s perinatal quality collaborative. - Substance use, mental health and informed consent: advocates and psychiatrists emphasized that maternal mental health (including overdose and suicide) is a leading cause of pregnancy‑associated death and pressed for policies that protect patient trust. Ashley Sawyer of Pregnancy Justice and psychiatrist Dr. Frank Dowling supported the Maternal Health Dignity and Consent Act (S.845 in the Senate) and said routine, surreptitious toxicology testing and automatic reporting to child‑welfare authorities undermine care and deter people from seeking prenatal services. - Home visiting and navigation: proponents of Nurse‑Family Partnership and other home‑visiting programs described how early, sustained nurse visits identify hypertension, mental‑health needs and other risks that can lead to poor outcomes. Hospital witnesses urged creation or funding of perinatal navigator roles to connect patients to postpartum appointments, lactation and social supports.

Questions and follow‑up requests: Senators asked the department for more granular morbidity analyses and for copies of hospital hemorrhage protocols required under past law. The Department of Health said it conducts on‑site reviews after serious events and uses the Maternal Mortality Review Board for deeper investigation; it also said it would provide additional requested data to the committee.

Where lawmakers may act next: legislators repeatedly framed the issue as a mix of budget and policy choices — expanded and sustained funding for community programs, workforce training and retention, support for doula/ midwife reimbursement and clearer rules around testing and reporting. Several senators and witnesses mentioned the Child and Family Well‑Being Fund proposal and other bills and budget items that would direct resources to community supports rather than surveillance‑first responses.

Taper/next steps: Department officials told the committee they intend to continue the perinatal quality collaborative, expand training and pursue community partnerships, while legislators signaled follow‑up requests for specific data (doula enrollment, hemorrhage protocols, county‑level morbidity analysis) and said they would consider budget and statutory changes to accelerate proven interventions. Several panelists asked for quicker implementation timelines and clearer accountability when local or facility practices deviate from state clinical guidance.